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At least 19 recordsLinked to original sources
PubMed1976

Recent survey of infectious meningitis in adults: review of laboratory findings in bacterial, tuberculous, and aseptic meningitis.

Infectious meningitis in adults was reviewed to establish the frequency of meningitis due to each causative agent and to reexamine the laboratory parameters that help to distinguish aseptic, bacterial, and mycobacterial meningitis. Aseptic meningitis occurred 2.2 times more often than bacterial and mycobacterial meningitis combined. The most common nonviral causative agent was the pneumococcus (23 cases) followed by the tubercle bacillus (11 cases) and the meningococcus (5 cases). Cerebrospinal fluid (CSF) Gram stain was the most useful study to rule in a bacterial cause: 89% of cases of bacterial meningitis had a positive initial Gram stain. Hyponatremia occurred in 73% of cases of tuberculous meningitis; hyponatremia combined with a negative Gram stain was highly suggestive of a tuberculous cause. One third of all patients with tuberculous and aseptic meningitis had a predominance of neutrophils in the CSF. No patient with aseptic meningitis had a CSF while count higher than 2,800 cells/cu mm or a CSF protein value higher than 250 mg/100 ml. Other reviews confirm this if cases due to lymphocytic choriomeningitis (LCM) are excluded. One patient with tuberculous meningitis in this series, and none of those cases reviewed, had a CSF white count higher than 1,200 cells/cu mm. Only 3.7% of the patients with aseptic meningitis had hypoglycorrhachia. Series reporting exclusively disease due to mumps and LCM have a higher frequency of hypoglycorrhachia.

Adult↗
PubMed1978

Experimental pneumococcal meningitis. IV. The effect of methyl prednisolone on meningeal inflammation.

This study was undertaken to determine whether adrenal corticosteroids suppress meningeal inflammation in experimental pneumococcal meningitis in rabbits and, if so, whether the mechanism of suppression involves inhibition of chemotactic activity in CSF or modification of granulocyte responses to inflammation mediators. It was found that methyl prednisolone, administered intramuscularly in doses of 15 or 30 mg/kg 24 hr and 48 hr after induction of meningitis, significantly reduced (p less than 0.01) the mass of granulocytes present in the meninges 72 hr after infection, the time of maximum meningeal inflammation. The larger dose of steroid produced approximately twice the suppressive effect of the smaller dose (p less than 0.05). The regime of methyl prednisolone that produced maximal suppression of meningeal inflammation (30 mg/kg/day) did not alter CSF chemotactic activity or chemotactic responsiveness and phagocytic activities of granulocytes from rabbits with meningitis. However, steroid therapy inhibited an increase in granulocyte adherence that was observed in untreated animals with meningitis (p less than 0.05). Thus methyl prednisolone in doses of 15 and 30 mg/kg given daily to rabbits with pneumococcal meningitis produced a suppressive effect on meningeal inflammation that was dose-dependent and was possibly mediated by inhibition of granulocyte adherence.

Animals↗
PubMed2026

How Do Climatic Factors Directly Influence the Incidence and Risk of Meningococcal Meningitis Across the African Meningitis Belt? A Narrative Literature Review.

Globally, the highest incidence of meningococcal meningitis occurs within the African meningitis belt, spanning 26 countries across sub-Saharan Africa. Meningococcal meningitis incidence is highly seasonal in this region specifically, with outbreaks mostly occurring during the dry season, characterized by low rainfall and atmospheric humidity, high temperature, and increased dust and wind speed. The strong seasonality of meningococcal outbreaks coincides with seasonal variation in climatic factors. This multicollinearity can make it difficult to identify environmental drivers of disease and the mechanisms by which they operate. This review aims to collate existing evidence to better clarify the mechanisms by which climatic variables influence meningococcal meningitis incidence. We examined the impact of dust, wind speed, temperature, rainfall, and land cover on meningococcal meningitis outbreaks. Within the literature, atmospheric dust and wind speed had the strongest statistical association with meningococcal outbreaks and demonstrated greater predictive probability than other climatic variables. However, several climatic factors have demonstrable influences on one another, reflected in the seasonality of meningococcal meningitis. Atmospheric dust can reduce precipitation levels in part through its radiative properties. Decreased rainfall and increasing temperatures can dry out soil, increasing its availability to be uplifted as dust. Alongside, this lower atmospheric humidity increases evaporative demand, leading to faster soil moisture loss and enhanced surface drying. We argue that rainfall, temperature, and land cover variability may act as part of a broader climatic mechanism, increasing atmospheric dust. This increases the incidence and risk of meningococcal meningitis.

Africa↗
PubMed1978

Meningeal exudate cells in vaccinia meningitis of mice: role of local T cells.

Intracerebral inoculation of vaccinia virus into adult DDD mice produced intensive meningitis several days after infection. The inflammatory reaction could be quantitated by counting cells obtained from this inflammatory lesion. The local virus titer increased until day 5 and subsequently decreased rapidly with time. Concomitant with this titer decrease, numerous meningeal exudate cells appeared in the lesion. The cytotoxic activity of these cells against vaccinia virus infected cells was studied after removal of glass-adherent cells. The results showed that these meningeal exudate cells possessed cytotoxic activity against the virus-infected cells and moreover inhibited plaque formation by vaccinia virus. The magnitude of this activity was much larger than that of spleen cells obtained from the same animals. After treatment with antithymocyte serum, or with antitheta serum plus complement, the meningeal cells lost their inhibitory activity, suggesting that the cells which exerted the effect were mainly T lymphocytes. The meningeal exudate cells obtained on day 7 postinfection were further characterized. A greater part, approximately 80%, of the cell population was composed of theta-positive cells. Less than 1% carried immunoglobulin, 7% possessed neither theta antigen nor immunoglobulin on the surface, and 12% represented glass-adherent cells.

Animals↗
PubMed1977

Pathogenesis of neonatal Escherichia coli meningitis: induction of bacteremia and meningitis in infant rats fed E. coli K1.

Escherichia coli K1 strains, isolated from human newborns with meningitis, were fed to pathogen-free Sprague-Dawley infant rats by an oral gastric tube. Feeding of 10(3) to 10(11) organisms colonized the intestine of approximately 70% of the animals. At 5 days postfeeding of 3- to 5-day-old rats, bacteremia was detected in 60%, and meningitis occurred in 15% of bacteremic animals. Colonization and bacteremia were age-related. Rats 15 days old had only 19 colonization and 10% bacteremia, and those 30 days old were almost completely resistant to colonization and bacteremia. The intranasal route was less effective in inducing colonization and bacteremia. Intralitter transmission from E. coli K1-fed rats occurred, with 52% of water-fed controls becoming colonized and 15% become bacteremic. Colonization of mothers from their fed infants occurred, but none of five tested developed bacteremia. Other E. coli capsular polysaccharide types were studied. A K92 strain isolated from a newborn with meningitis induced a 77% colonization rate, and 8% of these developed bacteremia without detectable meningitis. An E. coli K100 strain showed a 32% colonization rate, and 2% developed bacteremia. The age relation, relatively high virulence of K1 compared with other capsular types, spontaneous appearance of colonization, bacteremia, and meningitis, and intralitter transmission of colonization and disease in newborn rats closely parellel E. coli epidemiology in human neonates.

Administration, Oral↗
PubMed1976

Possibility of diagnosing meningitis by gas chromatography: cryptococcal meningitis.

Cerebrospinal fluid (CSF) from eight patients with cryptococcal meningitis, from ten patients with viral meningitis, and from four control patients without meningitis were analyzed by electron-capture gas-liquid chromatography (EC-GLC). All cryptococcal specimens had similar EC-GLC profiles, and these differed from those of the controls. Viral EC-GLC patterns were different from those obtained with specimens from the patients with cryptococcal infection and from the controls. In addition, specimens from patients with various types of viral infections gave profiles that differed from each other. Two normal CSFs were inoculated with Cryptococcus neoformans; aliquots of these cultures showed an EC-GLC pattern very similar to that seen in CSF of patients with cryptococcal meningitis. The EC-GLC procedure is rapid, reproducible, and easy to perform and may hold promise as an additional aid in the diagnosis of cryptococcal infection.

Cerebrospinal Fluid↗
PubMed1976

Treatment of overt meningeal leukaemia in children: results of second MRC meningeal leukaemia trial.

After induction ofmeningeal remission by a course of intrathecal methotrexate patients were randomly allocated to receive either cranial irradiation or craniospinal irradiation. Patients being treated for their first meningeal relapse were randomised separately from those in their second or subsequent relapse. All eight patients in their first relapse who were given cranial irradiation alone developed further meningeal recurrence (median length of remission 15 weeks) compared with only two out of nine given craniospinal irradiation (median length of remission at least 99 weeks). Four of the nine patients given craniospinal irradiation were alive and without further meningeal relapse two and a half to four years after treatment. Craniospinal irradiation produced no such advantage for patients entering the trial in their second or subsequent meningeal relapse.

Brain↗
PubMed1978

Cerebrospinal fluid and serum immunoglobulins and antibody titers in mumps meningitis and aseptic meningitis of other etiology.

Cerebrospinal fluid (CSF) and serum from 19 patients with mumps meningitis and 19 patients with meningitis of other etiology were investigated on two or more occasions for at least 1 month after onset. Intrathecal synthesis of immunoglobulin (Ig) G was found in 55%, of IgA in 26%, and of IgM in 24% of the patients. Oligoclonal Ig was demonstrable by agarose gel electrophoresis in 37% of the patients, mostly already during the first week after onset, and could persist for years. Mumps virus antibody synthesis within the central nervous system occurred in 37% of the mumps meningitis patients. The inflammatory reaction within the central nervous system as reflected by mononuclear pleocytosis, Ig synthesis, and oligoclonal Ig was not correlated to the clinical course. The blood-brain barrier was evaluated by determination of the CSF total protein, CSF/serum albumin ratio, and CSF/serum alpha2-macroglobulin ratio. A significant correlation was found among these three parameters. Persistence of the elevated CSF/serum albumin ratio seems to influence prognosis, and this parameter is recommended for evaluation of the blood-brain barrier function.

Antibodies, Viral↗
PubMed1977

Rapid diagnosis of lymphocytic meningitis by frequency-pulsed electron capture gas-liquid chromatography: differentiation of tuberculous, cryptococcal, and viral meningitis.

Cerebrospinal fluid specimens from patients with tuberculous (17 cases), cryptococcal (15 cases), and viral (14 cases) meningitis were analyzed by frequency-pulsed electron capture gas-liquid chromatography and mass spectrometry. Compounds that disappeared after therapy were found to be present in each of these specimens and were not detected in controls. They occurred in repetitive patterns such that these three types of meningitis could be rapidly distinguished. The compound associated with tuberculous meningitis has been tentatively identified. These finding have implications for rapid diagnosis, pathophysiological studies, and possible new therapeutic approaches.

Chromatography, Gas↗
PubMed1978

Non-group D streptococcal meningitis misidentified as enterococcal meningitis. Diagnostic and therapeutic implications of misdiagnosis by screening microbiology.

Two patients had nonhemolytic Gram-positive coccal meningitis. Both pathogens were initially misidentified as a group D enterococcus by growth in "selective" media, which led to the use of inappropriate and potentially toxic systemic and intrathecal aminoglycosides. Careful evaluation of the antibiotic sensitivity data and additional microbiological studies allowed correct identification of the organism. The important diagnostic and therapeutic considerations in differentiating true enterococcal infections, especially meningitis, from those caused by other alpha-hemolytic or nonhemolytic streptococci are emphasized. A simple laboratory schema for rapid recognition of such pathogens is reviewed.

Adult↗
PubMed1976

A controlled study of intrathecal antibiotic therapy in gram-negative enteric meningitis of infancy. Report of the neonatal meningitis cooperative study group.

Eighteen institutions collaborated in evaluating the comparative efficacy of combined ampicillin and gentamicin therapy with and without intrathecal administration of gentamicin on the clinical and bacteriologic responses of 117 infants with meningitis caused by gram-negative enteric bacteria. There was a random distribution of patients within the two study groups with regard to age on enrollment, birth weight, sex, race, number of infants greater than 30 days of age, the etiologic agent, and their antimicrobial susceptibilities. There were no statistically significant differences (P greater than 0.05) in mortality, morbidity, or days that cerebrospinal fluid cultures remained positive among the infants in the two treatment groups. The case fatality rate for all patients was 32%; that for full-term infants (18%) was significantly lower (P less than 0.01) than that for low-birth-weight infants (45%) or for the patients greater than 30 days of age (48%). Fifty-one of the 80 (64%) survivors were assessed as normal on follow-up examinations performed up to four years after illness.

Ampicillin↗